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INTERVIEW


“WE ALL HAVE TO OWN IT AND NOT ASSUME OBESITY IS SOMEONE ELSE’S PROBLEM – IT’S NOT JUST FOR DOCTORS TO SORT OUT”


Many experts have drawn a parallel


between the detrimental effects of smoking and the dangers of a sedentary lifestyle. After the publication of the Doll and Hill study into the link between smoking and lung cancer in the early 1950s, Kelly says that most doctors changed their own smoking habits almost overnight: “Even today it’s still very rare to see a doctor, in the UK at least, who is a smoker. They’ve been fantastic role models for us all. “GPs have been one of the major ways


we’ve achieved success in the cessation of smoking. It leads us to assume that if they can become as single-minded in their recommendation of physical activity, they could play a very important part in the whole process.”


CARROTS AND STICKS An added complication with treating the so-called lifestyle diseases is that they involve tackling the complex issue of human behaviour. To this end, Kelly says NICE is currently updating its 2007 guidelines on behaviour change. “It’s one thing to resolve to change your behaviour and quite another to have continuing benefi cial behaviour,” he explains. In terms of such behaviour


modifi cation, Kelly seems to be in favour of both the carrot and the stick. “Nudge is one of the approaches, because it picks up on an important dimension in human


Kelly says there is now “compelling” evidence about the benefi ts of exercise


behaviour: our response to cues in our environment which don’t require much perception or cognitive activity. “But nudge isn’t the whole story.


We’re also rational-thinking human beings and need information on which to base our decisions. Sometimes we can’t be nudged without the right kind of framework being put in place.”


BRIEFING: PROFESSOR KELLY


Professor Kelly is director of the Centre of Public Health Excellence at NICE, where he leads on the development of public health guidance. He is a public health practitioner, researcher and academic. He studied Social Science at the University of York, has a Masters degree in Sociology from the University of Leicester, and undertook his PhD


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in the Department of Psychiatry at the University of Dundee. His interests include evidence-based


approaches to health improvement, coronary heart disease prevention, chronic illness, disability, physical activity, health inequalities, behaviour change, social identity and community involvement in health promotion.


Read Health Club Management online at healthclubmanagement.co.uk/digital To return to the case of smoking,


Kelly points out that across the decades there have been some very effective public education campaigns, a gradual ‘denormalising’ of the act of smoking, increasingly fearful advertising, the banning of ads on cigarette packets, and ultimately the ban on smoking in public places. “All of these things together have led


to a remarkable improvement in people’s health with regards to heart disease, cancer and chest illnesses,” he says. But these changes took 60 years to happen and Kelly acknowledges that with the obesity and lifestyle disease ‘time-bomb’, we cannot afford to spend as long forming a solution. He admits it may take a while for some GPs and other professionals to embrace the message of physical activity, but says: “The decisive change hasn’t happened yet – it’s been a rather slow burn – but I’m optimistic we’re talking about the medicine of the future.” ●


February 2013 © Cybertrek 2013


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